PB2462: IMPACT OF ENGRAFTMENT SYNDROME ON THE DEVELOPMENT OF GRAFT-VERSUS-HOST DISEASE IN ALLOGENEIC/HAPLOIDENTICAL PERIPHERAL BLOOD HSCT IN A SINGLE CENTER IN MEXICO.
Authors: Juan Daniel Garza Escobar, Severiano Baltazar Arellano, Guillermo Sotomayor Duque
Journal: HemaSphere (2023)

Topic: 22. Stem cell transplantation - Clinical Background: Described by Spitzer and Maiolino, engraftment syndrome (ES) is a well-known complication in hematopoietic stem cell transplantation (HSCT), with an incidence of 47% in its allogeneic modality. Manifesting close to the graft. Relating to the development of graft-versus-host disease (GVHD). Aims: To establish an association and impact of ES with GVHD in patients undergoing allogeneic/haploidentical HSCT. Methods: Retrospective, cross-sectional and analytical study, which included patients with benign/malignant hematological disease who underwent allogeneic/haploidentical HSCT of peripheral blood aged 1-65, between January 1, 2020, and June 1, 2022. To define the ES Maiolino criteria were used. The descriptive analysis was performed with absolute frequencies, percentages, and measures of central tendency. A simple linear regression was performed to assess the relationship between ES and GVHD. Using the Kaplan-Meyer method, OS was analyzed in allogeneic/haploidentical HSCT, in those who presented ES. Results: 96 patients were included, 37/96 (38.5%) were allogeneic and 59/96 (61.5%) haploidentical, 60.4% were male and 56.3% adults. 78.1% malignant pathologies. Predominantly acute leukemia 45/96 (46.9%), lymphoblastic 38/45 (39.6%) and myeloblastic 7/45 (7.3%). Group and Rh incompatibility were reported in 35/96 (26.1%) minor 14/35 (14.6%) and major 11/35 (11.5%). In 31 months of follow-up, 25/96 (26%) died. The most common cause of death was secondary to an infectious process (36%), progression of the disease (32%) and GVHD (20%). Presenting higher mortality in haploidentical HSCT with 16.6%, compared to allogeneic (9%). Median myeloid and platelet engraftment days of 14 days (10-38 days). Median CD34 + 1.03 x10*6/Kg (1.6-132 x10*6/Kg), median follow-up was 9 months (1-31 months). Those who underwent allogeneic HSCT had a median age of 28 (1-57) years, 83% with malignant pathology, infusing a mean CD34+ of 18.8x10*6/Kg. 62.2% of the population developed ES, and GVHD occurred in 16 patients. When performing a linear regression model between ES and GVHD, a statistical correlation was found (p= 0.037). In the haploidentical group, the median age was 14 years (1-64), with a predominance of acute leukemias and other conditions (57.6%), the median CD34+ was 12.8 x106 (2.2-138 x106). 28.8% developed ES and 42.4% presented GVHD. And by the linear regression model a correlation was found (p=0.027). For OS, no statistical difference was found between both modalities of HSCT (p= 0.656), for those who developed ES (p= 0.305) and for the haploidentical group that developed GVHD (p= 0.267) and for the allogeneic group that developed GVHD (p= 0.257). Summary/Conclusion: A relationship was found between the history of ES and the development of GVHD, without impacting the OS of patients undergoing allogeneic/haploidentical HSCT.Keywords: Engraftment syndrome, Haploidentical stem cell transplantation, Allogeneic hematopoietic stem cell transplant